‘Components of Care’ approach | ‘Goals of patient care’ approach |
---|---|
Applies to small % of patients | Applies to large % of patients |
Inconsistently records surrogate decision-maker and available advance care planning documents. | Routinely records surrogate decision-maker and availability of advance care planning documents. |
Completed just before death, often by non-treating team | Proactively completed as part of routine care by treating team |
Part of overall treatment plan, with 4 specific goals | |
Medical escalation plan outlining use of individual components of treatment | Medical escalation plan which is goal and system oriented |
Associated with sub-optimal care | Associated with improved quality of care |
Misses patient preferences | Seeks and records patients’ goals, values and preferences. |
Sequential model of care with sharp demarcation from life prolonging care to palliative care | Introduces symptomatic palliative care earlier in illness trajectory |
Hospital, time limited, medical treatment order (ie doctor to doctor communication) | Orders can be endorsed beyond the current admission (potential to be an ongoing advance care plan) |